FRAMINGHAM HEART STUDY: Pioneering work led to common advice for health living

Henry Schwan hschwan@wickedlocal.com @henrycojo

Sunday

Oct 28, 2018 at 12:01 AMOct 28, 2018 at 12:00 PM

A Natick man said he wished he paid more attention to risk factors before suffering a heart attack, If he had, he may have avoided a health scare.

FRAMINGHAM – Greg Tutuny didn’t see it coming.

After a round of golf, dinner, and some time relaxing in his favorite chair at home, Tutuny suffered a heart attack – at the age of 54.

The Natick resident was rushed to the hospital, where doctors inserted a stent to clear a blocked artery.

The ordeal came as a shock, because Tutuny thought he was healthy.

However, there were signs of risk.

Tutuny’s diet included a healthy dose of sweets, including a bowl of ice cream every night. His exercise schedule was sporadic, and his job as executive director at the Natick Service Council had its share of stress.

He didn’t know it, but Tutuny’s lifestyle fit the profile of someone living with risk factors that could result in heart attack or stroke.

Understanding risk factors and taking steps to live a healthy lifestyle to minimize the chances of a health crisis are recommendations that were repeated by medical experts who spoke with the Daily News.

“(Heart disease) is a real risk for each one of us,” said Dr. Vasan Ramachandran, principal investigator and director of the Framingham Heart Study.

The Framingham Heart Study was the first to identify risk factors for heart disease. That happened in the 1960s, and was a groundbreaking development in preventive cardiac care. The list includes age, sex, smoking, high cholesterol, high blood pressure, weight and diabetes.

The study celebrates its 70th anniversary this month. Heart Study researchers have followed four generations of participants to identify the common factors that contribute to cardiovascular disease, the leading cause of death in the United States. It accounts for about one in three deaths in the United States, according to the American Heart Association.

A heart attack happens when blood flow that carries oxygen to the heart is severely reduced or cut off. Buildup of fat, cholesterol and other substances, collectively called plaque, can narrow coronary arteries that carry blood to the heart. If plaque breaks, a clot can form, severely limiting or blocking blood flow to the heart. Starved of oxygen and other nutrients, a section of heart muscle can suffer damage that can be fatal.

Blockage is also responsible for stroke, the fifth leading cause of death in the United States, and the leading cause of disability. It occurs when a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot. Blood flow is also disrupted when the vessel bursts. The result is a part of the brain lacks the blood and oxygen it needs, so brain cells die.

Genetic risks contribute to heart attack and stroke, Ramachandran said, but there are steps individuals can take to minimize risks. One is regular doctor visits.

Tutuny, who suffered his heart attack last year, now has annual checkups scheduled with his cardiologist.

“It’s critical,” Tutuny said of those appointments.

Lifestyle choices play a significant role in heart disease, Ramachandran said, like smoking, drinking alcohol and amount of exercise.

Before his heart attack, Tutuny said he didn’t have the healthiest diet. Now, he stays away from foods high in sugar, and loads up on fruits, vegetables and fish. He’s lost 30 pounds since his heart attack.

“I’m in the best shape of my life,” he said.

Reducing stress is another strategy to limit risks, a recommendation Tutuny received from his cardiologist. When he’s feeling stressed at home or work, Tutuny takes deep breaths to relax.

“I don’t worry about stuff I can’t control,” he said.

Ultimately, knowing the signs and symptoms of heart attack and stroke before catastrophe strikes is paramount.

“It’s very important that every individual in the United States knows the signs and symptoms of cardiovascular disease so they can get prompt, immediate care,” said Dr. Emelia Benjamin, a professor of Medicine and Epidemiology at Boston University and a clinical cardiologist at Boston Medical Center.

Symptoms can include numbness in the face, feelings of indigestion and slurred speech, Benjamin said.

For the past 30 years, Benjamin has conducted research at the Framingham Heart Study, and thinks the vast majority of coronary heart disease and stroke can be postponed or prevented.

Secondary occurs after a stroke or heart attack. It emphasizes aggressive treatment of risk factors to prevent or minimize the recurrence of a health complication.

Primary prevention is for those who already exhibit risk factors, like smoking or high cholesterol, and addressing them before the onset of heart attack or stroke.

Primordial prevention is removing risk factors from daily living. If they don't exist, then they can’t lead one down the road to possible health problems.

Benjamin is a proponent of the American Heart Association's "Life's Simple 7." It's a list of seven steps anyone can take to improve their health, including manage blood pressure, control cholesterol, reduce blood sugar, get active, eat better, lose weight and stop smoking.

She acknowledged heredity plays a role in cardiovascular disease, and so do socioeconomic factors. In some low-income communities, she said, there are higher rates of smoking and obesity, and access to exercise facilities can be limited.

Despite those challenges, Benjamin recalled something her father used to say that is simple and profound.

“My father gave an old adage, ‘An ounce of prevention is worth a pound of cure,’” Benjamin said. “It’s very important to identify risk factors and treat them.”

More than a year after his heart attack, Tutuny echoes that adage.

“I probably could have prevented my heart attack,” he said.

Follow Henry Schwan on Twitter @henrymetrowest. He can be reached at hschwan@wickedlocal.com or 508-626-3964